数字化仿真技术在股骨干骨折髓内钉固定术中的应用

doi:10.13418/j.issn.1001-165x.2020.03.016

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (3): 327-330.doi: 10.13418/j.issn.1001-165x.2020.03.016

数字化仿真技术在股骨干骨折髓内钉固定术中的应用

戴海¹，　黄宗贵¹，　吴永祥¹，　毕振宇²，　黎裕明¹，　徐应龙¹

1.南宁市第一人民医院创伤骨科，南宁 530022；　2.南方医科大学人体解剖教研室，广东省医学
生物力学重点实验室，广州 510515

收稿日期:2019-08-10 出版日期:2020-05-25 发布日期:2020-06-02
通讯作者: 毕振宇，博士，E-mail：lybimail@126.com
作者简介:戴海（1971-），男，主任医师，主要从事创伤骨科，E-mail：daihai2014@163.com
基金资助:
南宁市科学研究与技术开发计划项目（20133176），广东省医学科研基金（A2019334）

Application of digital simulation in intramedullary nailing for treating femoral shaft fracture

DAI Hai ¹, HUANG Zong-gui ¹, WU Yong-xiang¹, BI Zhen-yu², LI Yu-ming¹, XU Ying-long¹

1. Department of Orthopedics, The first People’s Hospital of Nanning，Nanning 530022, Guangxi Province, China; 2. Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou 510515, Guangdong Province, China

Received:2019-08-10 Online:2020-05-25 Published:2020-06-02

摘要/Abstract

摘要： 目的　探讨数字化3D模型虚拟手术对闭合复位顺行带锁髓内钉固定术治疗股骨干骨折的指导意义，评估其对治疗效果的影响。方法　选取本院2013年1月至2016年12月，闭合复位顺行带锁髓内钉固定术治疗的股骨干骨折病例80例，随机分为2组。研究组术前进行CT图像三维数字化重建并模拟手术过程，用以指导实际手术操作；对照组按照常规检查制定手术方案。比较两组手术时间、X线照射时间、术中出血量及术后随访情况。结果　研究组的手术时间、X线照射时间与对照组相比均有统计学差异，术中出血量无统计学差异。患者术后切口均Ⅰ期愈合，无感染等并发症。随访16~38个月，患者完全痊愈后均未发生疼痛，步态正常，均恢复日常生活及髋关节正常活动。X线片复查示骨折愈合良好。结论　股骨干骨折髓内钉固定术前进行3D重建及虚拟手术可指导手术过程，提高手术效率，具有较好的临床应用价值。

关键词: 股骨干骨折, 　髓内钉, 　虚拟手术, 　三维数字化模型

Abstract: Objective　To investigate the effects of closed reduction anterograde locking intramedullary nailing in the treatment of femoral shaft fractures with digital 3D model virtual surgical scheme.　Methods　From January 2013 to December 2016, 80 cases of femoral shaft fractures were treated with closed reduction and anterograde interlocking intramedullary nail. They were randomly divided into two groups: a treatment group and a control group. The treatment group underwent three-dimensional digital reconstruction of CT images, simulated the operation process, determined the selection of instruments and the location of nailing, and operated according to the virtual simulation scheme. The control group was given routine examination and surgical treatment. The operation time, X-ray time, intraoperative bleeding volume and prognosis were observed and followed up.　Results　There were statistical difference in the operation time and X-ray irradiation time of the treatment group from those in the control group, but there was no significant difference in the amount of bleeding during the operation. All the incisions healed in the first stage without any complications such as infection. The follow-up period ranged from 16 to 38 months. All patients recovered completely without pain and abnormal gait, and resumed normal daily life and hip joint activities.　Conclusions　Preoperative 3D reconstruction and virtual surgery for femoral shaft fracture with intramedullary nailing can significantly guide the surgical process, it is valuable for clinic application.

Key words: Fracture of femoral shaft, 　Intramedullary nail, 　Virtual surgery, 　Three-dimensional digital model

中图分类号:

R683.42

戴海, 黄宗贵, 吴永祥, 毕振宇, 黎裕明, 徐应龙. 数字化仿真技术在股骨干骨折髓内钉固定术中的应用[J]. 中国临床解剖学杂志, 2020, 38(3): 327-330.

DAI Hai , HUANG Zong-gui, WU Yong-xiang, BI Zhen-yu, LI Yu-ming, XU Ying-long . Application of digital simulation in intramedullary nailing for treating femoral shaft fracture[J]. Chinese Journal of Clinical Anatomy, 2020, 38(3): 327-330.

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数字化仿真技术在股骨干骨折髓内钉固定术中的应用

Application of digital simulation in intramedullary nailing for treating femoral shaft fracture

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